Takagawa J, Maruyama M, Yoshida Y, Arai N, Matsui S, Yamashita N, Sugiyama S, Kobayashi M
First Department of Internal Medicine, Faculty of Medicine, Toyama Medical and Pharmaceutical University, Japan.
Nihon Kokyuki Gakkai Zasshi. 1998 Jun;36(6):519-23.
A 46-year-old man with a history of left upper lobectomy for pulmonary tuberculosis was admitted to our hospital because of dilated cardiomyopathy. During hospitalization, fever and weight loss developed. The cause was suspected to be a round mass inside a cavity and a neighboring infiltrative shadow in the left upper lung field as seen on chest radiography. A percutaneous needle biopsy was done, and examination of the specimen showed an aggregate of Aspergillus fumigatus hyphae. Fluconazole (FCZ) was injected through an intracavitary catheter every day, and was then given by mouth. Treatment with FCZ was effective temporarily. However, he was again admitted to our hospital because of lower extension of the cavity and deteriorated inflammatory findings. From the clinical course, chronic necrotizing pulmonary aspergillosis was diagnosed. Treatment with all available antifungal agents did not improve his condition. Although he had decreased cardiac function due to dilated cardiomyopathy, partial pulmonary resection was done. The cavity with the fungus ball was resected completely. As of the time of this writing, he remains free of aspergillosis.
一名46岁男性，有因肺结核行左上肺叶切除术史，因扩张型心肌病入住我院。住院期间，出现发热和体重减轻。胸部X线检查发现左上肺野有一空洞内圆形肿块及邻近浸润影，怀疑是病因。进行了经皮针吸活检，标本检查显示有烟曲霉菌丝聚集。每天通过腔内导管注入氟康唑（FCZ），然后口服给药。FCZ治疗暂时有效。然而，他因空洞向下扩展及炎症表现恶化再次入住我院。根据临床病程，诊断为慢性坏死性肺曲霉病。使用所有可用的抗真菌药物治疗均未改善其病情。尽管他因扩张型心肌病导致心功能下降，但仍进行了部分肺切除术。完全切除了有真菌球的空洞。截至撰写本文时，他未再发生曲霉病。
